- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $10,506.16 / $21,899.37
| Facility | | $5,463.36 | $10,506.16 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,992.68 / $9,476.87 / $17,790.50
| Facility | | $6,992.68 | $9,476.87 | $17,790.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $755.77 / $1,331.06 / $8,632.00
| Facility | | $755.77 | $1,331.06 | $8,632.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,235.00 / $1,689.95 / $2,366.81
| Facility | | $1,235.00 | $1,689.95 | $2,366.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |